Thermal capsular shrinkage for shoulder instability. Mid-term longitudinal outcome study.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Multidirectional or capsular stretch-type shoulder instability presents a clinical challenge.
• Traditional open capsular shift procedures carry significant morbidity.

Purpose of the Study:

• To evaluate the short- and medium-term clinical outcomes of thermal capsular shrinkage for shoulder instability.
• To compare laser-assisted capsular shrinkage (LACS) with radiofrequency (RF) capsular shrinkage.

Main Methods:

• A comparative study involving 56 patients (61 shoulders) treated with LACS and 34 patients (38 shoulders) treated with RF capsular shrinkage.
• Patients were followed for mean periods of 40 months (LACS) and 23 months (RF).
• Clinical outcomes were assessed using the Walch-Duplay and Constant shoulder scores.

Main Results:

• LACS group: Mean Walch-Duplay score improved to 90, then plateaued at 80; 59% reported significant improvement, with a 36.1% failure rate.
• RF group: Mean Walch-Duplay and Constant scores were 80; 76.3% reported significant improvement, with a 23.7% failure rate.
• RF results were comparable to open inferior capsular shift outcomes for multidirectional instability.

Conclusions:

• Thermal shrinkage, particularly RF, is a viable alternative to open capsular shift for shoulder instability due to its minimal morbidity.
• RF capsular shrinkage demonstrated a higher patient satisfaction rate and comparable failure rates to LACS and open procedures.